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Resources on Activity-based Recovery Programs

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 If you are thinking of participating in an activity-based neural recovery program, here are some important questions to consider and discuss with people at the clinic and your health care team:

> Is it safe? Private clinics are not subject to the same evaluation and certification bodies that hospital or health research institutes are subject to. Ask questions about what they do in case of emergency, and whether the equipment they use is regularly inspected and serviced.

> Are the claims of effectiveness being made realistic? It is not possible for anyone to guarantee recovery of function for those who participate in these programs. Ask questions about what to expect and set realistic goals. If questions or suggestions about your medications or medical management arise while participating in such a therapy, we suggest you discuss this with SCI physicians or clinicians before making any significant changes independently. 

> Is the intensity of the therapy right for me? Physical activity and exercise is a very important part of wellbeing and health after SCI, however complications of SCI can be worsened through high intensity workouts, for example, worsening of spasticity, skin irritation leading to risk of pressure sores, and episodes of autonomic dysreflexia. 

> Does the staff have experience and education needed to work with SCI clients? Make sure the staff conducting or supervising your therapy are trained in SCI complications and concerns. Consider whether exercise program staff are certified or regulated by a licensing board which requires regular training/continuing education and has a process for complaints and accountability. 

> Is the cost worth it for me? Private clinics are often not covered by public health programs or other medical insurance, and costs can become significant with long or intensive therapy regimens. Consider the additional costs such as travel, and accommodation, especially if the private clinic lies outside of your community.

Exercise is an important part of staying healthy

It is important to have a clear understanding of the likely results of this type of treatment, as there is not yet enough research to indicate it is effective. Work with your health care team to ensure private activity-based therapy is safe and appropriate for you, and carefully consider its benefits, risks and costs. Check out our list of SCI fitness centres and services for more on what’s available near you.

SCI exercise and fitness centres near you 

Look in your area for centres that are supported by universities and medical centres, or run by certified professionals who are experienced in SCI, such as physiotherapists and exercise physiologists. Some centres we know about or are affiliated with include:

> Physical Activity Research Centre (PARC) at ICORD (UBC/SCI-BC, Vancouver, British Columbia), a spinal cord injury fitness and research centre offers state-of-the-art fitness equipment designed with SCI in mind, and on-site support to enable people with SCI in the Vancouver area to participate in physical activity. icord.org/parc

> Power Cord Exercise Program (Brock University, St. Catherine’s, Ontario) has specialized exercise equipment, on-site support and is overseen by SCI researchers. brocku.ca/health-well-being/power-cord-program

> MACWheelers (McMaster University, Hamilton, Ontario) is an adapted exercise program at McMaster University in Hamilton, Ontario, with one-on-one assistance from a student volunteer to support participants to carry out their exercise programs on innovative adaptive fitness and robotic gait training equipment. pace.mcmaster.ca/programs/mac-wheelers

> The SCI Fitness and Wellness Centre (University of Calgary, Alberta), is a personalized fitness program for people with SCI that is also affiliated with SCI Alberta. It has specialized exercise and assistive equipment and fitness coordinators to support your exercise routine. sci-ab.ca/programs_services/fitnesscalgary

> Get in Motion (McMaster University, SCI-BC and SCI-Ontario) is a free SCI physical activity counselling service for Canadians designed to provide you with the information and support you may need to recognize and meet, your personal physical activity goals. All physical activity counselling is done over the telephone and is provided by specially trained peers with a physical disability. sciactioncanada.ca/get-in-motion.php

If specialized SCI-specific exercise rehabilitation gyms are not available in your area, contact your rehabilitation physician, physiotherapist or occupational therapist for more information on how to access adaptive equipment and exercise facilities in your area.

For more information on some of the individual therapies included in some activity-based recovery programs, consult Spinal Cord Injury Research Evidence (SCIRE), a web-based summary and critical review of existing scientific literature on a broad range of topics in SCI rehabilitation. SCIRE resources are public but have been designed for use by clinicians and researchers.